switching pain meds

[oldnightrider]

I need a liver soon. New pain DR. wants to switch me from 120 #4 dilaudid a month that I just started taking 3 wks ago to fentanyl and 40 #4 dilaudid. What do you all think?. Also I should mention that whatever I do could effect weather I get a liver or not If they think I really need what I am taking since I had A drinking problem but not in over a year. I go to AA several times a week.

[skmedlin27703]

I am on Fentanyl and I like it.  I dont like the dilaudid b/c it messes with my vision and gives no real pain relief, I like the oxycodone 15mg for breakthru pain... but everyone is different, I would give it a try

[femmy29]

Hi and welcome to the pain management community!

I would seek out advice from the medical facility that has placed you on the donor list for a liver transplant to understand fully what can disqualify you for a liver transplant.  If you are prescribed the Fentanyl and Dilaudid for pain associated with liver failure, I highly doubt that these meds will disqualify you from a liver transplant but PLEASE seek clarification that this is the case.  In these types of situations, it is always best to seek out clarification.  Lastly, Fentanyl is one of the the better medications for those with renal (kidney) or heptic (liver) impairement.  Dilaudid is as well.  Oxycodone (with and without tylenol) and Hydrocodone are both not recommended due to the additional metabolism by the liver into oxymorphone and hydromorphone, respectively.  There is still some work on the liver regardless to process opioids but Fentanyl, Dilaudid (hydromorphone), and Opana (oxymorphone) put less strain on the liver.  

Please keep us updated on how you are feeling and the status of your transplant.  I wish you all the best!

femmy

[Magnum]

Have you ever contacted Dr. Robert Gish? He's a Hepatologist and assistant chief of liver transplants for the West  Coast, and a professor at U of San Diego. He's on top of all liver problems / transplants.

Here is his contact number. 619-543-6303,4 or 619-543-5415

Talk to whoever answers and ask if you could submit a couple of questions regarding your liver situation. He's world renowned... Good luck...

Magnum